from the staying-alive-is-getting-more-expensive dept.
EpiPen's price has ballooned about 400% since 2008, rising from about a $100 list price to $500 today. The EpiPen is one of the most important life-saving medical innovations for people with severe food allergies—which affect as many as 15 million Americans and 1 in 13 children in the United States. But its price has exploded over the last decade despite few upgrades to the product itself. The product's lack of competitors is likely a significant driver of the costs. [...] [The] EpiPen enjoys a near-monopoly on the market with annual sales of more than $1.3 billion and nearly 90% U.S. market share.
Related Stories
AlterNet reports
The [EpiPen], which millions of Americans depend on, was invented in the 1970s by engineer Sheldon Kaplan[PDF], who died seven years ago in modest surroundings amid obscurity. But Kaplan's patent made its way into [the] Netherlands-based drug maker Mylan, which, since 2007, has jacked up the price of the spring-loaded injector from $57 a shot to $300.
[...] The high price [...] caught the attention of Dr. Douglas McMahon. The 38-year-old allergy specialist in St. Paul, Minnesota, has been thinking about how to improve on the EpiPen and to do so in a way that's affordable.
[...] McMahon saw that the EpiPen device was not only overpriced for what it does but also was too big to be easily carried in a pocket. For the past couple of years, he has been tinkering with injection-device components in his lab. And the result of his work is AllergyStop [1], an injection prototype that's small enough to fit on a key chain. McMahon claimed his device is as effective as the EpiPen and can be marketed and sold for about $50.
But, even though McMahon's device has been production-ready for the past two months, the steps he must take to get the device approved will cost him about $2 million and it will potentially take him years to go through all the hurdles required by the U.S. Food and Drug Administration for possible approval of his invention.
[1] All content is behind scripts. archive.li will run those for you.
Previously:
EpiPen's Price Increased 400% since 2008
If you're going to overcharge the U.S. government, you don't want to get caught:
Mylan NV for years overcharged the U.S. Medicaid health program to buy its EpiPen shot, the government said Wednesday, despite being told that it needed to give bigger discounts under the law. From 2011 to 2015, the joint state-federal program for the poor spent about $797 million on EpiPens, the Centers for Medicare and Medicaid Services, or CMS, said in a letter Wednesday. That included rebates of about 13 percent, but the U.S. should have been getting a larger discount of at least 23.1 percent.
While the agency didn't say exactly how much Mylan had overcharged, the amount could be substantial. Under law, companies are required to give [Medicaid] back any price increases they take on brand drugs above the rate of inflation, in addition to the 23.1 percent discount. Mylan, after acquiring the drug in 2007, has raised the price of EpiPen by about sixfold, to over $600 for a package of two. The government has in the past "expressly told Mylan that the product is incorrectly classified," CMS said in the letter, which came in response to an inquiry by Congress. "This incorrect classification has financial consequences for the amount that federal and state governments spend because it reduces the amount of quarterly rebates Mylan owes for EpiPen."
Previously:
EpiPen's Price Increased 400% since 2008
AllergyStop: $50 EpiPen is Production-Ready but...
In a press release Thursday, the National Institutes of Health reported an addendum to its official guidelines for Diagnosis and Management of Food Allergy. The specific change is intended to address the precipitous rise in peanut allergies which has occurred recently. For many years, parents have been strictly advised to avoid exposing babies to peanuts, eggs, and other potential allergen foods, on the hypothesis that early exposure could be dangerous and exacerbate problems in those children likely to develop allergies.
The new guidelines are a complete reversal in that the NIH now recommends earliest exposure (4 to 6 months) for children at most risk of developing allergies, such as those with severe eczema and/or known egg allergies. Other children should also have peanuts -- though not whole ones, which can be a choking hazard -- introduced into diets freely along with solid foods. The new guidelines are based on results from the landmark Learning Early About Peanut Allergy (LEAP) study. From the NIH press release:
"The LEAP study clearly showed that introduction of peanut early in life significantly lowered the risk of developing peanut allergy by age 5. The magnitude of the benefit and the scientific strength of the study raised the need to operationalize these findings by developing clinical recommendations focused on peanut allergy prevention," said Daniel Rotrosen, M.D., director of NIAID's Division of Allergy, Immunology and Transplantation.
CNN reports on the history of the LEAP study, noting that there was an earlier practice in Israel to expose children to peanuts as early as possible. Anecdotally, these children had a much lower frequently of allergies than Israeli children raised in the UK. The LEAP study thus assigned over 600 children randomly to a group with early exposure or a group which avoided peanuts completely for the first 5 years of life. The results were striking:
All the children participating in the study were at high risk of peanut allergy due to family history or having eczema or egg allergy themselves, said Nepom [one of the developers of the LEAP study]. At age 5, the children in both groups were given peanuts and observed, Nepom said: Eighteen percent of the children who had been avoiding peanuts had a peanut allergy at age 5, compared with only 1% of the children who had been introduced to peanut butter or Bamba early in life. "This showed that early introduction of peanut flour had over 80% prevention effect," Nepom said.
The study and the new NIH guidelines represent one of the most scientifically rigorous rationales to reconsider allergy guidelines in general. Proponents of early exposure to problematic foods, along with the hygiene hypothesis, claim that the obsession with avoiding exposure to potential allergens in early life has actually caused the current epidemic of allergies. Approximately 1 in 13 children in the U.S. has a food allergy; over 2% alone have peanut allergies. While death from anaphylaxis after exposure is relatively rare, various studies indicate that peanuts are likely the most common trigger in children and frequently result in hospital visits. The NIH policy change is also quite relevant, following the extended national debate on cost of anaphylaxis medication, particularly the outrageous prices for EpiPens (see SoylentNews coverage here, here, and here).
Just months after an outcry about a price hike for the life-saving "Epipen", CVS pharmacies will begin carrying a new generic injector at a cutthroat price:
Pharmaceutical giant CVS announced Thursday that it has partnered with Impax Laboratories to sell a generic epinephrine auto-injector for $109.99 for a two-pack—a dramatic cut from Mylan's Epipen two-pack prices, which list for more than $600 as a brand name and $300 as a generic.
The lower-cost auto-injector, a generic form of Adrenaclick, is available starting today nationwide in the company's more than 9,600 pharmacies. Its price resembles that of EpiPen's before Mylan bought the rights to the life-saving devices back in 2007 and raised the price repeatedly, sparking outcry. [...] The price of $109.99 for the alternative applies to those with and without insurance, CVS noted. And Impax is also offering a coupon to reduce the cost to just $9.99 for qualifying patients. [...] Meanwhile, backlash to Mylan's price hikes continue. This week, Cigna, a top health insurance company, said that it will no longer cover Mylan's brand name EpiPen—it will only cover the generic, which was rolled out in December.
Previously: AllergyStop: $50 EpiPen is Production-Ready but...
Mylan Overcharged U.S. Government on EpiPens
Dr. Lowe, from In the Pipeline, writes about the company responsible for EpiPen, with quotes taken from The New York Times:
To understand Mylan’s culture, consider a series of conversations that began inside the company in 2014.
In (2014) meetings, the executives began warning Mylan’s top leaders that the price increases seemed like unethical profiteering at the expense of sick children and adults, according to people who participated in the conversations. Over the next 16 months, those internal warnings were repeatedly aired. At one gathering, executives shared their concerns with Mylan’s chairman, Robert Coury.
Mr. Coury replied that he was untroubled. He raised both his middle fingers and explained, using colorful language, that anyone criticizing Mylan, including its employees, ought to go copulate with themselves. Critics in Congress and on Wall Street, he said, should do the same. And regulators at the Food and Drug Administration? They, too, deserved a round of anatomically challenging self-fulfillment.
[...] As the article says, the company has decided that all the criticism is just the cost of doing business, and that their business is selling EpiPens at the highest cost they can. Bad press, upset parents, calls for them to change – none of that means much.
[...] Another thing that happens when you operate this way is that other government agencies get motivated to take a closer look at you. Last fall, Mylan paid $465 million to settle a misclassification problem that led to them getting higher rebates than they should have on EpiPens distributed through Medicare. But now it appears that there’s another $1.27 billion involved, according the the Health and Human Services Office of the Inspector General.
[...] As it happens, some of the company’s investors are trying to replace the board members, and just this morning, ISS (Institutional Shareholder Services) came down on their side. They’re recommending that shareholders vote against ten directors and against ratifying the compensation plans for the top executives. That’s a pretty big deal, since ISS handles the proxy voting for a lot of big investors and funds, and if given the go-ahead can vote things en masse. This, you can be sure, is a cause for concern in the upper suites, and it should be.
http://blogs.sciencemag.org/pipeline/archives/2017/06/12/mylan-begins-harvesting-the-crop-its-sown
https://www.nytimes.com/2017/06/04/business/angry-about-epipen-prices-executive-dont-care-much.html?_r=1
http://www.fiercepharma.com/pharma/mylan-investors-rally-votes-against-chairman-coury-and-his-97m-pay-package
Previous Coverage of Mylan and their Practices:
https://soylentnews.org/article.pl?sid=16/10/06/021244
https://soylentnews.org/article.pl?sid=16/08/23/0136202
(Score: -1, Flamebait) by Anonymous Coward on Tuesday August 23 2016, @07:34AM
OmabacARE fixed evry fuckIng think!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Makeinng a bifference!!!!!!!!!!!!!!!!!! FOR THE WORSTTTTT
(Score: 3, Insightful) by Gravis on Tuesday August 23 2016, @08:02AM
just let people die until the price comes down. ;)
(Score: 5, Informative) by davester666 on Tuesday August 23 2016, @08:56AM
I believe that is the Republican plan for health care in general once ObamaCare is repealed.
(Score: 2) by CirclesInSand on Tuesday August 23 2016, @12:06PM
No, the free market solution is to eliminate patents. The price of an epi pen would be $20 dollars or less, and for safety, you could just look up reviews and audits of the product by multiple private organizations (rather than a single government organization that can be bought so easily).
(Score: 2) by Kilo110 on Tuesday August 23 2016, @12:44PM
Why would any company invest in R&D if their product can be reverse engineered and replicated before they can recoup their costs?
Also in theory other private organizations could review and test for safety, but in practice it doesn't really happen. See the lack of regular open source code auditing and the too few replication studies done in academia.
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @01:31PM
first mover advantage. reputation, quality control.
there are many ways to make it profitable.
or at the very least compromise to limit patent to only 1 year monopoly.
patents are out of control and are the largest money suck in our healthcare system.
Capitalism and free markets are good,
monopolies/bailouts and cronyism supported but liberals and statists are evil.
(Score: 2) by HiThere on Tuesday August 23 2016, @03:09PM
I think a 5 year monopoly is generally justifiable. 10 years if there is a large amount of required initial investment...but you should need to really prove the requirement. And patents should be unenforceable against individuals whose income is less than half of yours...without allowing either party exemptions. Perhaps also companies should not be able to enforce patents against other companies whose income was less than half of theirs, but I'm less certain.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @04:09PM
That would not be enough to even cover the costs of a Phase I clinical trial. It would maybe be enough for the pre-clinical work.
(Score: 4, Insightful) by jelizondo on Tuesday August 23 2016, @02:46PM
Children, children... read history instead of playing Pokémon...
In an interview [nytimes.com], after the Ann Arbor conference, Murrow asked Salk, "Who owns the patent on this vaccine?" Salk magnanimously replied: "Well, the people, I would say. There is no patent. Could you patent the sun?"
Not everything should be about profit, particularly not when dealing with human health and life.
No profit on saving lifes? I guess that makes a communist...
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @04:16PM
To be fair, the Salk vaccine was just inactivated virus. Could you patent the virus or the formalin-inactivation of the virus?
I'm all for universal healthcare, but patents are useful for drugs with high development costs while we have a for-profit system.
(Score: 2) by Kilo110 on Tuesday August 23 2016, @07:58PM
Modern drug development is high risk and high cost. A pharma company may go through dozens of possible drugs until they land one that works and is safe. This means considerable cost to bring a single drug to market. If there's no assurance of at least breaking even (forget about profit for now) no one would take that risk.
It's all well and good to pooh-pooh the evil capitalists and their greed for profit. But the labs need to be furnished. Lights and water kept running. Researchers need to be paid. Studies to be run on the safety and efficacy of drugs. If all of that work and investment can be cancelled out by some generics drug manufacturer on a shoe-string budget a quarter or two after launch, it'll be for nothing. And development costs will only increase as new complex and powerful technologies are introduced. Stem cells, dna editing, who knows what else.
Lastly. There's no need to be condescending by calling everyone children. Can we all act as adults here?
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @08:36PM
Also, without patents companies would rely on drugs being a black box that are protected trade secrets or have increasingly complex formulations to prevent reverse engineering.
(Score: 2) by turgid on Tuesday August 23 2016, @08:42PM
There is a powerful argument for state-owned, public-funded medical research. Let the bread heads do the easy less-risky stuff and the rest of us can pull together and look after ourselves.
I refuse to engage in a battle of wits with an unarmed opponent [wikipedia.org].
(Score: 1) by khallow on Tuesday August 23 2016, @10:42PM
There is a powerful argument for state-owned, public-funded medical research.
And that powerful argument is?
Let the bread heads do the easy less-risky stuff and the rest of us can pull together and look after ourselves.
There is nothing too risky for the private world. There are purely private markets that have risk that makes the medical industry look tame (such as the sea salvage industry or oil well fire fighters). They do just fine without government funding.
I think the real powerful argument here is that government is notorious for coming up with rules and spending that don't reduce risk or make us safer, including the medical industry and medical research, but make everything cost a lot more.
(Score: 3, Insightful) by jelizondo on Tuesday August 23 2016, @11:55PM
Oh, my god.
You mean as long as it is profitable it is free enterprise and we hate the government; as soon as large loses loom, flip-flop, we love the government and please bail us out.
Please stop watching Fox News, their universe is completely different from the one you and I live in.
(Score: 0, Troll) by khallow on Wednesday August 24 2016, @12:20AM
You mean as long as it is profitable it is free enterprise and we hate the government; as soon as large loses loom, flip-flop, we love the government and please bail us out.
You know, you could think. So let's try that. What is the research that is so expensive and so risky, yet still has a huge return on investment to justify public funding rather than private? Sorry, it doesn't exist. Even stuff like space stations or large particle colliders are within the grasp of the private world. Instead, we see the usual squandering of public funds on scientific white elephants, and people with a remarkable willful ignorance of economics.
(Score: 2, Insightful) by Anonymous Coward on Tuesday August 23 2016, @10:53PM
state-owned, public-funded medical research
This, together with GP's on-target use of "Communist", gets top marks from me.
...and isn't most fundamental biological research already being done in public universities?
Biologists and physicians, am I wrong?
...and for those who aren't aware, USA's healthcare costs are the highest[1] on the planet and the results are far from the best.
[1] USAians spend ~3x what Britons do and Cuba (with its minimal monetary resources) bests USA in several ways in quality of outcome--largely through easy access and early intervention.
-- OriginalOwner_ [soylentnews.org]
(Score: 2) by jelizondo on Tuesday August 23 2016, @11:47PM
Sorry if I caused you offense.
The effect intended was sarcasm together with the fact that I'm usually the oldest person around fora like this. (At Soylent I suspect only Runaway1956 is in my league, maybe a couple of others who might have encountered 80-column cards used in real-life.)
The sarcasm part is due to younger people believing that the “correct” way is the modern may, even if other ways might be possible and even desirable. And even if the results are less than desirable, such as big pharma milking consumers, kids insist on there being only the market as a solution.
When I was young, no thinking bro would defend the status quo and in return we got civil rights, a presidential resignation and good music. Now, it seems to be the opposite, if you are right thinking, then you must defend the Establishment.
Now, I figure I’m ready for disposal, in my previous post I forgot to add: Get off my lawn! :-)
(Score: 1, Informative) by Anonymous Coward on Wednesday August 24 2016, @02:00AM
The largest cost for a new drug is marketing, none of that boring research stuff.
Also if you don't pay to send doctors on junkets, who is going to trick all your customers into buying your 'medicine'?
(Score: 5, Insightful) by CirclesInSand on Tuesday August 23 2016, @03:50PM
Why would any company invest in R&D if their product can be reverse engineered and replicated before they can recoup their costs?
The idea that humans won't research new products unless the government grants market monopoly is so bizarre that it makes a person wonder how anyone with any exposure to humans could believe it. Creating new awesome things is what humans do, it's an evolutionarily defining characteristic of humanity.
Just because the government forcefully involves itself in human activity doesn't mean they are helping. An analogy I heard once was a random man jumping in front of a parade and pretending to be leading it.
Have you ever actually met an engineer before? I don't mean some kid trying to get a college degree to make money, I mean the kind of person who has half disassembled appliances all over their house, and more tools than clothes. Try stopping that person from inventing new things; it cannot be done.
But since you did ask for a business motivated example reason, here is one among many: a small company would research a new product to make a name for themselves so they can overtake the larger company. And when the larger company tries to copy the smaller company's product, the smaller company has already researched something new again. You can't play catchup forever and you also can't reverse engineer good customer service and a good reputation. Investors will be able to distinguish between an old bloated inflexible copycat company and a new company with new ideas.
The reason this new research doesn't happen is because of patents. Why bother doing new research if some large company with a huge patent portfolio is just going to sue you? Patents don't promote research, they destroy it.
And I think that if you consider it even briefly, the reason why "open source" and "academia" are not counter examples to business auditing should be obvious. The keyword is "business". A counter example would have to be an area where a business should be audited, the government hasn't done it, and the markets haven't moved to do it either. You can literally find private reviews of the temperature gauges in outdoor grills.
(Score: 1, Informative) by Anonymous Coward on Tuesday August 23 2016, @04:27PM
Have you ever actually met an engineer before?
Have you met a pre-clinical biologist, toxicologist, medicinal chemist, analytical chemist, clinical trial director, lawyer, and doctor all rolled-up into someone rich enough to actually be able to "tinker" with drug development?
Medical science costs a lot of money and, currently, the public does not want to pay for academics or the government to do all the steps. There are also many laws that are in place to protect patients, lab animals, neighbors, and the environment from the products and waste from the drug development process.
(Score: 4, Informative) by CirclesInSand on Tuesday August 23 2016, @06:34PM
Again, the position that researchers will never work together to develop new products unless the government gives them market monopoly. It's absolutely bizarre that anyone takes this seriously.
There's a ton of voluntary public funding for research, and for all the costs you mentioned, they are nothing compared to the cost of having your research be illegal because of patent infringement.
Furthermore, development in medicine isn't (usually) made in enormous leaps, it is made in small steps. Small steps depend on previous small steps being available to improve upon. Patent infringement prevents this. We can only imagine how many medicines haven't been developed at all because researchers weren't allowed to work on illegalized-by-patents life saving research.
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @08:31PM
estimates of drug development costs are around US$1.3 billion to US$1.7 billion.
Researchers would love to work together, but it is a question of resources. I would be happy if the US government or a non-profit would dump that kind of money into developing drugs without patents.
I'm also not convinced that fear of patent infringement is what is holding any of this back. If you mean incremental changes on small molecule drugs, then that already happens in pre-clinical development otherwise the abysmally low clinical trial success rate would be even lower. If you mean patents are interfering with academic research, then you are way off.
http://m.ctj.sagepub.com/content/early/2016/02/06/1740774515625964.full [sagepub.com]
(Score: 2) by Kilo110 on Tuesday August 23 2016, @09:24PM
I agree but you’re not factoring in barrier to entry. Drug development is highly technical and very expensive and risky. A basement tinkering who likes to disassemble appliances can NEVER by himself develop a drug.
This is just fantasy. Modern drug development is incredibly complex and incredibly risky. Pharma houses simultaneously research dozens of drugs in hopes that a handful actually work and are safe. They fully expect most of their work is wasted but they still research it because you don’t know which avenues will bear fruit until you researched it. There’s no way a small startup can out-research a big company. By the time the startup has finished one research project. Big pharma has completed 6.
No No! Just the opposite. Remember how most of their research will fail? The revenue from the sales of the successful drugs pays for all the failed research. And companies are OK with failing because they know they’ll be able to still fund development due to patents on the successes. Killing off patents entirely will KILL research into all but a handful of possibilities. This is NOT good as many drugs will be left undiscovered if never researched. We can discuss the appropriate length of a patent, but killing it off entirely will have the opposite effect.
I referenced those examples since you said the pharma market would govern itself on safety. Those are both real life systems that use peer auditing as quality control. Open source requires others programmers to volunteer their time to vet the code. Academia requires other scientists to run replication studies to vet their findings. Yet neither of those really happens to the degree as needed. Your proposed system also requires companies/individuals to volunteer their time and effort to proof others companies work. If it doesn’t work in open source development or academia, why would it work in pharmaceuticals? You vaguely mention “business” and gas grill thermostats. But the qualifications and cost to review a gas grill thermostat are significantly lower than to analyze a new drug molecule and review their research. Furthermore, the effects of an incorrect review are significantly different as drug efficacy and safety studies are a literal matter of life and death.
(Score: 0) by Anonymous Coward on Wednesday August 24 2016, @02:11AM
Consumers care for none of that. They want it cheaper. Why else all the fuss over Chinese imports killing American jobs.
Investors also wouldn't care. If a group of investors have enough money they can produce more of your product, faster than you can. Economies of scale and cheap land, labour, regulations, will eat your lunch. You make something new, I'll copy that too, thanks.
(Score: 2) by edIII on Tuesday August 23 2016, @08:35PM
Recouping costs is one thing. That is NOT what is happening here.
This is AVARICE. Watch Michael Moore's "Sicko" and you can see people getting meds for nickel for the same stuff that costs over $100 in the U.S. It's the same reason why there are huge buses of senior citizens going to Canada to get drugs.
All of the executives deserve to burn in hell. While they're still here before they get there, we should dox every one of those fuckers. Why?
So when they go into a restaurant they're ice tea is $49.50. They're side of fruit $93.75. The full meal is $432.68.
When they complain to the rest of us, we can ask them back why the fuck is a life-saving EpiPen all of the sudden $500? When they respond tongue-in-cheek about RoI and we, the unwashed masses, are simply too ignorant about business and Capitalism, we can respond right back, "No, we learned quite well. That's why your meal is $432.68 and only cost us $8.00 to make in the kitchen. We know you will be back, because like life saving drugs, you have choice but to eat, or die".
Technically, lunchtime is at any moment. It's just a wave function.
(Score: 0) by Anonymous Coward on Thursday August 25 2016, @09:23AM
We know you will be back, because like life saving drugs, you have choice but to eat, or die".
Let me remind you its illegal to prepare your own meal from stuff you can get. We have "Worked With Congress" to have Law passed. You are not a certified chef and cannot prepare food. Even your own.
Thank you, Congress, and let me Shake Your Hand, for passing legislation for my business model and taxing the people to support armed enforcement personnel if needed to protect my business model!
(Score: 2, Interesting) by Anonymous Coward on Tuesday August 23 2016, @08:10AM
There is competition. Auvi Q. I actually prefer the Auvi Q because they are smaller. The problem is they are the same price. Without any kind of insurance they are about $700 US last time I checked. Fortunately, my insurance covers them. They also have ridiculous expiration dates. As long as they are stored properly, I have seen them last more than a year passed the date. As long as the liquid is clear and not cloudy or discolored, they are ok to use. If you don't believe me, ask your favorite search engine.
(Score: 1, Informative) by Anonymous Coward on Tuesday August 23 2016, @08:16AM
Are you affected by the recall? https://www.auvi-q.com/ [auvi-q.com]
(Score: 2) by bradley13 on Tuesday August 23 2016, @08:36AM
Price in Switzerland, which is a high-cost country: $75. [compendium.ch] You can order them online from Canada for $112. [canadadrugs.com] If they cost $700 in the US, something is very wrong. Probably something called "Obamacare".
So buy a stock of the things abroad, and look into refrigeration. The rule of thumb is that each 10 degrees (celsius) of temperature reduction should double the life. Room temperature is 20C, so refrigeration just above freezing should quadruple the life. According to the online information, they are normally good for 17-24 months, so refrigeration should extend this to 6-8 years.
IANAMP (MP = medical professional), but a good pharmacist should be able to confirm whether or not there are any problems with refrigeration.
Everyone is somebody else's weirdo.
(Score: 5, Informative) by pe1rxq on Tuesday August 23 2016, @09:00AM
The price hike started years before Obamacare. The fact that you blame it anyway is a good indicator why corporations get away with such greedy behavior.
(Score: 3, Interesting) by kurenai.tsubasa on Tuesday August 23 2016, @09:39AM
Aww, shoot. Here I was going to post that with so many more people that Obamacare is giving EpiPens to, it's only natural that the price go up!
(I mean, that's a natural consequence of scale, right? Bulk orders always cost per unit at least 150%–300% the cost of a single unit!)
Oh, oh, I know! I've got this one! It's to cover all the R&D! There. No mystery now! How could we continue to have EpiPens without billions of dollars of R&D per year/month/decade (pick a unit that makes the 109 figure reasonable) that those cheapskate RestOfTheWorlders are stealing from us without paying a fair price! We spend soooooo much on R&D! Everyone else are a bunch of rotten freeloaders!
You're welcome, Big Pharma. I'll take my fee in Bitcoin. Usual address.
(Score: 2) by FatPhil on Tuesday August 23 2016, @02:22PM
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @03:44PM
No true bitcoiner uses the same address twice!
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @08:05PM
The price hike started years before Obamacare
In fact one of the stated goals of Obamacare was to reduce costs. Hmm that didnt work.
Here is why it did not work. Money.
The market will react to money. As you add in more money into a system inflation will occur. This happens because people are more willing to pay more. How did people afford to pay more? Tada... insurance. We made it wildly cheaper on the front end ('free' or 'only 50 dollar copay'). Then on the back end there was no cost controls (more competitors, laws, etc). So the cost naturally begins to match the real market value. That is the 'invisible hand'. If I give everyone in the world 1 billion dollars a loaf of bread is no longer worth a couple of bucks. It is worth a LOT more in monetary terms. Value wise it is the same. Same thing here. Less competitors, more money into the system = higher costs for the consumer.
Obamacare was nothing more than a giant mandated insurance scheme. So naturally with the new found cash the insurance companies went on a buying spree. The drug companies had to deal with less consumer competition (they sell to the insurance companies not you). So less competition there. The drug companies flush with more cash did inversions to reduce their tax loads and bought competitors out. So less competition there as well. Price *WILL* rise in an environment like that. Insurance rates are going up this year as well. By many estimates nearly 10-15 percent and deductibles are going from what used to be 50 or 10% pay to 5000 and 40% pay (I have seen as high as 70%).
The reality is Obamacare made things worse in many ways and better in a few. Mandated employer insurance (hillarycare) was one of the key points of why we are in this mess as is. My father sold medical insurance for years. Most 65+ year olds had insurance that was maybe 50-200 bucks a month (full coverage). Same insurance now is well over 1000 per month. The day they passed the PPO/MMO stuff my dad came home and said 'by the time you are 50 you will not be able to afford insurance'. It is looking like he was right. This insurance mess has been going on for a long time. Obamacare is just the latest iteration.
(Score: 2) by pe1rxq on Tuesday August 23 2016, @08:24PM
Mandatory Insurance is not the problem.
1000 a month? I pay a little bit more per year and the healthcare system in my country is at least as good as that of the US (depending on who is making the list it might be better
Just because the US manages to fuck up does not make it a bad concept. There are enough counter examples.
(Score: 2, Insightful) by Anonymous Coward on Tuesday August 23 2016, @10:10PM
Just because the US manages to fuck up does not make it a bad concept. There are enough counter examples.
I totally agree. However, we were discussing Obmaacare which has been a clusterfuck from top to bottom.
For example my state requires you to buy car insurance to drive a car. I can chose from 20-30 different companies. At the Obamacare level? I have maybe 3-4 to chose from. I used to help my dad with the billing. For insurance companies they try to sell you it in this order. Group -> Life -> medical -> vision -> dental -> car. In that order from best profit to least. Group insurance is basically hillarycare (Health Security Act of 1993). Medical is basically Obamacare. Group was typically a perk companies would use to attract better workers. You could buy full medical coverage before 1992 for about 15-250 a month depending on conditions and age.
As you know other countries usually use a variation of single payer or managed care. To equate it to what we have is kinda silly. It is also typically just collected as a tax. Instead of causing millions of people to do even more paper work then the doctors have to basically play insurance chicken and hope you are covered.
I mention what I call lovingly 'insurance chicken'. They submit and see what happens. That is exactly how many doctors offices do it. Submit a 80 dollar cotton swab. If the insurance pays 'woot'. If not, oh well, bill the customer. If they dont pay it write it off or submit to collections and call it a deduction. Even though they were maybe a nickle out of pocket.
My mother was in the hospital last year. They gave her 4 Tylenol pills. The charge on that? 120 dollars. Oh it was out of my moms personal supply from her purse. They charged her to give her purse to her. They spent months arguing with the hospital about all sorts of things they charged that never happened. All of it submitted to insurance. Until my mom went thru each charge with the doctor line by line. They turned a 30k visit into a 300 dollar one. Why does the hospital do it? They GET AWAY WITH IT all the time. No one really cares 'insurance pays it'. Yet everyone bitches that particular items cost goes up. Well yeah because 'no one cares, insurance pays it'. I have lost count the number of nurses, doctors, and secretarys that have said those words 'who cares insurance pays it'. Then if you get 'cost conscious' on them they turn into 'not covered'.
(Score: 2) by VLM on Tuesday August 23 2016, @11:49AM
I'd be careful because a soul-less evil corporation could trivially add a viscosity thickener such that if its at fridge temperature the injection is slow as molasses. Hmm you can't breathe due to bee string and the injector is in slow motion, lets see how this turns out...
Whew luckily we strongly regulate and control our monopoly providers, you know, like firefighters and air traffic controllers and medical. Oh wait... well at least we know epi-pens are not monopoly provided by soul-less evil corporations... oh wait...
Of course where your strategy would work is if you get a bulk deal on qty ten for $6500, refrigerate 9, carry one, use one per year or whatever, etc.
(Score: 2) by driverless on Tuesday August 23 2016, @01:05PM
Price in New Zealand, about USD 87, and there's a good chance you can get the cost reimbursed by the government. Just over one tenth of the US price for the same product, if you have to pay for it at all.
(Score: 3, Insightful) by FatPhil on Tuesday August 23 2016, @02:35PM
If I visit the USA, should I just fill my suitcase with those? That would pay for my trip tenfold! (Not that I will ever go to the US out of principle - I don't support fundamentally corrupt regimes).
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 2) by FatPhil on Tuesday August 23 2016, @02:41PM
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 2) by compro01 on Tuesday August 23 2016, @09:28PM
The JR means it's a child dose. I think adult is about double that or something.
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @05:20PM
Fyi, they did make the importation of drugs illegal in the states.
(Score: 4, Interesting) by theluggage on Tuesday August 23 2016, @10:34AM
Fortunately, my insurance covers them.
Ding! We have a reason! This is the problem with any form of "insurance" in a "free" market - sellers charge what the market will bear and the lion's share of the market is "insurance companies". Not only can insurers bear sky-high prices, but they actually have an incentive to encourage them: if medical supplies are impossible for most people to afford without insurance, then, tadah! more people have to buy insurance. The insurance company doesn't care about absolute cost as long as its predictable - they just raise their premiums to match, and all their competitors are paying for the same products so they have no advantage. For that matter, I don't think the people selling insurance give a flying fuck about the value of future payouts - they're paid for selling policies and all the risk gets packaged and commoditised and resold on down the line.
Obviously there's a similar danger if the government is paying, but governments are rather more accountable for sky-high healthcare bills - taxpayers care if their money is being wasted, shareholders only care about the value of their shares & dividends, which are fine as long as money is flowing.
Of course, if the government was paying insurers to cover people then you'd have the absolute worst of both worlds, but obviously no civilised country would be so batshit insane as to set up a ridiculous scheme like that...
(Score: 2) by scruffybeard on Tuesday August 23 2016, @12:08PM
I would be shocked if your insurance company was paying $700 for them. I get routine blood work twice a year. The bill from the lab is usually about $150, but the insurance pays about $6, with no additional co-pays from me. Similar thing from the dentist. He might bill $200 for a filling, the insurance knocks it down to $120, which I split 80-20 with the insurance company.
(Score: 3, Interesting) by AthanasiusKircher on Tuesday August 23 2016, @03:41PM
I would be shocked if your insurance company was paying $700 for them. I get routine blood work twice a year. The bill from the lab is usually about $150, but the insurance pays about $6, with no additional co-pays from me.
THIS. Many people don't realize how much "insurance" really translates to "negotiated private deals with medical services/groups/suppliers." You go to the doctor and they bill you for "$200," but the only person who pays the $200 is the person without insurance. One insurance company pays $160, another pays $122, another pays $64, one lucky one pays only $40, or whatever. But then you receive the statement that the "$200 bill is settled."
The first time you see this, most people react with, "Huh?"
In reality, the doctor's office "charges" a number higher than it knows any reasonable insurer would pay. That way they get the maximum money out of everyone. And the person who is screwed the most is the person without insurance.
Same thing happens with medication, where insurers have deals with pharmacies and drug companies. I'm sure it's true here.
Important tip: Try to negotiate medical bills -- if you offer to pay cash quickly, you may be able to score a discount similar to insurance companies. (It helps if you have an idea of how much a private insurer would actually pay, but that's hard to find out.) Also, shop around for medication. Your "insurance" may NOT be giving you the best deal. A few years ago I needed a generic medication for a family member, and the "preferred pharmacy" the insurance recommended required paying a $16 co-pay for a 30-day supply. Then I went to the local grocery store pharmacy, and they offered the same generic drug at $10 for a 90-day supply (with no insurance). The system is completely messed up.
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @05:23PM
Even people without insurance don't pay full price, if they are smart. When I didn't have insurance, I would go to the doctor and just ask, "how much do I need to pay in cash, right now, to make this bill go away?" Almost always, I'd get at least a 60 percent discount as an initial offer. I'd always remind the office manager, who was almost always called by the desk jockey, that they were better off just taking my money now, then wasting it dealing with insurance or collections headaches.
Of course, the real way to fix this is to require doctor offices to do what every other business has to do: post their prices ahead of time so you can compare prices BEFORE you go. You'd be amazed what real competition can do. You already see this with the various retail clinics that have began to pop up. The nearby doctor's price for strep tests dropped by an order of magnitude after the nearby pharmacy started offering them.
(Score: 2, Informative) by Anonymous Coward on Tuesday August 23 2016, @12:42PM
Our corporate insurance rep come in the other month to go over a new policy. One employee started ranting about Obamacare and "fuckin Obama" at the end of the meeting. The rep flat out told my coworker "The insurance and drug companies are screwing you, not Obama." He quickly explained how Obamacare was stonewalled until a version written by the drug and insurance companies was passed. He also said a single payer system was certainly a better way to go even though it would be the end of his job. And this man has been selling insurance for over 20 years.
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @01:23PM
Yeah. It's surprising to me how many people can have the capacity for cognitive dissonance and immunity to information that leads them to still blame the ACA. Maybe it's the same utterly retarded tribalism that has people calling it Obamacare years after it's a done deal! People that absolutely thought that every provision of the ACA was a good idea. But OMG anything but Obamacare!
The person who negotiates our insurance every year is one such pants-on-head stupid dipshit. Any complaints anybody has about the plan she chose this year? Don't blame me, blame Obama!
One would have to be a complete and utter fucking born-yesterday naïve retarded Zika baby to have not figured out exactly why costs are out of control by now.
Americans are fucking idiots. I hope they keep shouting #1! #1! #1! when they're all subsistence farmers getting food aid from China.
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @02:22PM
While wearing "Make America Great Again" hats.
(Score: 2) by HiThere on Tuesday August 23 2016, @03:14PM
Personally, I still call it Romneycare, since he was the one that first proposed it.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2) by FatPhil on Tuesday August 23 2016, @02:29PM
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @03:48PM
Doubt he had much choice - the single payer thing was never going to get passed ( https://en.wikipedia.org/wiki/United_States_National_Health_Care_Act#Timeline [wikipedia.org] ). Obamacare is actually still a bit better than going with the flow. Seriously the USA healthcare system was so broken that something like Obamacare actually made it better in many ways (more got coverage).
The prices of medical care were still high before Obamacare and fewer people were covered.
And if you look at the insurance companies they have an incentive to sabotage Obamacare whenever they can: https://soylentnews.org/article.pl?sid=16/08/20/1626228 [soylentnews.org]
If US voters blame Obama for going for lesser evil instead of "voting" for something actually good, they should look at themselves. I see plenty of US voters voting for Hillary Clinton merely to avoid Donald Trump and vice-versa.
They shouldn't be surprised when they get what they vote for, or when the People's Representatives end up too representative of the People ;).
(Score: 2) by aclarke on Tuesday August 23 2016, @02:12PM
If insurance is the reason, why are they more like $100-150 here in Canada? At least in Ontario, OHIP doesn't cover medication, so we have to pay out of pocket for medicine here if we don't have insurance to cover it. If the complete answer is "because insurance" then they'd be a similar price in Canada to what they are in the US.
The answer here isn't "get rid of insurance". Maybe it's get rid of the "free" market and introduce regulations to limit corporate greed and protect citizens. In the end, I don't pretend to know the right answer either. But after experiencing the American health care system for close to a decade, I sure am glad to be back in Canada. I mean, American care is pretty good, as long as you have bulletproof insurance...
(Score: 2) by theluggage on Tuesday August 23 2016, @04:49PM
If insurance is the reason, why are they more like $100-150 here in Canada?
You mean, in Canada (where at least part of healthcare is public and the government makes the occasional gesture towards regulating industry) why is it somewhere between the US price (where you need insurance to pay for doctors, operations, ambulances, hospital beds etc. and the entire system is run for the benefit of the insurers) and the UK price (where you don't need insurance at all*)?
Sounds about right.
(* flat rate of £8 per prescription capped at a bit over £100/year total, unless you qualify for free prescriptions).
(Score: 1) by Guppy on Tuesday August 23 2016, @12:35PM
There's also the AdrenaClick. The formulary price in our office is cheaper than an EpiPen, but never actually seen one so I have no idea how good it is.
(Score: 2) by wirelessduck on Wednesday August 24 2016, @05:40AM
Looks like all Auvi-Q are being recalled :/
https://www.auvi-q.com/ [auvi-q.com]
https://www.auvi-q.com/recall-return-and-reimbursement-process [auvi-q.com]
(Score: 4, Interesting) by anubi on Tuesday August 23 2016, @08:16AM
Its a friggen dose of adrenaline....
Five Hundred Dollars?!???! Isn't this highway robbery?
I guess this is the kind of stuff that happens when our laws protect artificial monopolies.
Adrenaline has been around for eons. Why isn't this generic?
Seems like this oughta be a standard by now. Look at the other things found in the dollar store. Including medications.
Google for the cost of the actual chemical. Epinephrine. I am getting 52 cents a dose.
If its the damn injector, I'll take it by the bottle and use an insulin injector. One buys those by the box for around $15/box of 100.
Why can't I buy a bottle of the stuff if I need it? Government! The very same people who said they would "fight for me"!
I note during the gas crisis a few years ago, our governments enacted law against "gouging". Where are those laws now?
I am really beginning to really hate all this IP law our governments keep passing. All these monopolies enforced by our own government really brings out the greed in certain people.
If some kid dies because he could not get fifty-two cents worth of chemical, I feel some Congressmen should stand trial for accessory to murder.
"Prove all things; hold fast that which is good." [KJV: I Thessalonians 5:21]
(Score: 3, Informative) by sjames on Tuesday August 23 2016, @08:51AM
It's beyond highway robbery. They might as well put a cocked gun to a child's head and demand money.
All based on the belief that nobody but a highly trained medical professional can manage such complex instructions as stick needle in, push plunger.
We claim to be an advanced civilization, but we sacrifice children to Mammon all the time.
(Score: 5, Informative) by anubi on Tuesday August 23 2016, @10:46AM
Now, I find this....
Equine Pharmacy (Rx) Sedation & Anesthesia (Rx)
Epinephrine 1:1000 by Generic (brand may vary)
Epinephrine 1:1000 50 ml - Item # 1278RX
Epinephrine 1:1000 is indicated for emergency use only in treating anaphylactic shock. Usual dose for cattle, horses, sheep, swine is 1 ml per 100 lbs. of body weight, given IM or SQ.
QTY EACH
1278RX 50 ml $20.99 6 @ $19.99
729RX 30 ml Call for availability
Please note that this item requires a veterinarian's prescription.
Three convenient ways to do that are:
Let us contact your veterinarian for prescription authorization.
Your veterinarian can contact us by fax/phone.
You can mail us the original written prescription.
Buy more and save!
Buy 6 Epinephrine 1:1000 (item 1278RX) and save!
Here. [google.com] Click on the Valley Vet link.
$20 for about 50 doses.
If your kid was a 100 pound horse, that is...
What has me so all fired worked up is this is the same chemical needed to save a kid's life !!!!!
But if the child needs it, hold the parents hostage for whatever they can pay, cuz they play this trick on the horse owners, they might fight back.
This whole thing is one of the most egregious examples of politician-enabled thuggery I have seen to date.
"Prove all things; hold fast that which is good." [KJV: I Thessalonians 5:21]
(Score: 2) by sjames on Tuesday August 23 2016, @05:45PM
It's worse than you think. Based on the human child dose (EpiJr), it's 333 doses for $20.
Add in a pre-loaded 1ml syringe and a plastic tube to protect it and you might be up to $3/dose. At that price, a lot of people who 'choose' to risk it would be a lot safer.
Further, it would be safer to use. Even doctors have been confused by the EpiPen's design and ended up injecting their own thumbs rather than the patient. With a syringe, it's obvious even to a small child which end goes in the patient and which end you press.
The healthcare industry is riddled with this sort of price gouging and people do die as a result.
(Score: 1) by anubi on Wednesday August 24 2016, @05:01AM
I talked to a friend who owns some livestock earlier today. I am still quite incensed over this subject, and asked him about his experiences with health maintenance of his livestock. He tells me epinephrinine is one of the cheapest chemicals in his medical arsenal for taking care of his animals. At least, if I needed some, I know where to get some.
But not everyone knows or has access to the workarounds needed to survive in our political and legal environment.
We discussed an asinine scenario, but went something like this...
A child, playing in the pool, gets into trouble.
A business professional, see a business opportunity. He has a pole. He could pull the kid out. However, he wants $500 for pole rental first.
A bystander, also seeing what's going on says: "To hell with all that tie-talk! Can't you see that kid's drowning?". He jumps into the pool to get the kid out.
The business professional, seeing his business opportunity vanishing right in front of him calls security over... "He can't do that! He is NOT trained! Protect MY business model! My trade group has Worked with Congress to Pass Law requiring Medical Certification to allow someone to do this!!!"
If the kid dies, should the Business Professional be held liable for murder? Should the security man forcing the "Good Samaritan" not to act be held liable for accessory to murder? Should the Good Samaritan be held liable, even if he did not get it right, trying to help because the kid could not at the time come to the business terms demanded by the business professional? Should the Congressmen who voted it into Law that someone else could not help be accessory to murder as well?
Seems only our Government can see this in a business sense.
I am a child of the 50's and remember Vietnam war very well. Our government had no problem compelling young men to surrender their LIFE to the draft. To protect someone else's business models. Yet they can't handle something like one of the cheapest medications out there not to be marked up to insane levels just because they got some Congressmen to pass laws saying only medical professionals are allowed to practice medicine, then those professionals use the artificial monopoly created by government for them to insanely charge for their services?
If I had to choose between not having the chemical at all ( by reason of sheer economics ), or having to use the one intended for livestock, I'll go for the latter. The farmer wants his animals to live too.
This is a problem created by men of the handshake, suit, tie, and dollar. They need to fix it. Why we continue to refer to these people as "the honorable" is a puzzlement to me.
"Prove all things; hold fast that which is good." [KJV: I Thessalonians 5:21]
(Score: 0) by Anonymous Coward on Thursday August 25 2016, @03:16PM
Same reason men marrying female children was banned once women gained political power.
Messed up their biz model.
(Score: 2) by sjames on Thursday August 25 2016, @06:40PM
Indeed, it is outrageous, and it goes well beyond just epinephrine. Most of the prescription drugs for sale in the U.S. today are priced orders of magnitude higher than necessary to turn a decent profit and people do die as a result. When desperate people tried to vote with their feet and wallets by ordering from overseas, a law was passed to prevent it. Now otherwise ordinary people are forced to criminal activity just to stay alive.
Others who were in a better position to tough it out chose to simply have nothing to do with the healthcare system in the U.S. so that too was outlawed.
The suits responsible are actually worse than the people who charge $50 for a bottle of water after a natural disaster (highly illegal anywhere that has seen a natural disaster in recent memory). They actually dry up the cheap supplies (cause the disaster) and then gouge.
They don't deserve respect, they deserve to be spat upon in the street.
We know this is a solvable problem because literally every other first world country has done so.
(Score: 2) by AthanasiusKircher on Tuesday August 23 2016, @06:18PM
$20 for about 50 doses.
If your kid was a 100 pound horse, that is...
What has me so all fired worked up is this is the same chemical needed to save a kid's life !!!!!
But if the child needs it, hold the parents hostage for whatever they can pay, cuz they play this trick on the horse owners, they might fight back.
Here's the deal, which I'm surprised no one has really explained on this thread yet. The high cost for the EpiPen is NOT for the epinephrine (which, as you point out, costs next to nothing). The cost is for the delivery system, i.e., the "autoinjector."
The patent over these things expired a while back, but the FDA has been dragging its feet in approving generics, because they require studies to demonstrate that the generic versions have the same success rate and are as easy to use. Still, there are generics on the market, and you can get your doctor to prescribe one. But many haven't received "official" approval yet. (And even then, the generics appear to be priced at greater than $100, which is still preposterous in my opinion.)
Of course, the clear solution is simply to buy the ampules of epinephrine [pbs.org] for about $5/piece (safer to buy individual doses rather than the bulk horse amounts you listed for people unaccustomed to measuring syringes in emergency situations), and a couple generic syringes.
Although there is a little more you need to know about injecting epinephrine directly than using an EpiPen, it doesn't require a "trained medical professional" as some people claim. Any reasonably competent person can be taught the proper procedure and warnings in 15 minutes, rather than the 2 minutes you learn to use an EpiPen. And you'll save many hundreds of dollars.
This is a SERIOUS medical and budgetary issue not just for individuals but for emergency services. If you read the link I gave above, you'll see a story about a Fire Department which spends 3% of its operating budget each year just to stock EpiPens. The amount just for one year could pay for EMT training for five firefighters.
What we really need is more physicians willing to take the time and teach patients proper injection procedures. If there's concern about dosing and handling ampules, it's very easy to create a case of pre-filled syringes (filled by a "medical professional" if you really want to take the extra safety steps), which will be chemically stable and sterile for at least 3 months.
(Score: 2) by sjames on Wednesday August 24 2016, @02:36AM
For all the harping some organizations do about the EpiPen being easier and safer to use, I just don't see it. It's too easy for someone to take the pen analogy too far and hold the wrong end against the patient's leg while pressing the "button" on top like you would a ball point. OUCH!
OTOH, I can't think of anyone who wouldn't immediately know what end of the hypodermic syringe to apply to the patient.
The people concerned for safety need to realize that the fair comparison for many is pre-measured syringe or nothing at all. The $700 auto injector isn't even a contender.
(Score: 5, Funny) by Entropy on Tuesday August 23 2016, @08:40AM
It seemed really important to him. His eyes were desperate, like he was pleading for me to take it and keep it safe for him. Unfortunately he died a short while later(food allergy, I think), but I still have the Epipen he entrusted me with his dying wish... I'll keep it always.
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @11:10AM
Another police homicide.
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @03:24PM
Good god that is awful... and at the same time I can't stop chuckling. The sure sign of madness and the only "sane" reaction to such a unbelievable shittery on part of Big Pharma.
(Score: 4, Informative) by ledow on Tuesday August 23 2016, @08:47AM
https://onlinedoctor.lloydspharmacy.com/uk/allergy/epipen [lloydspharmacy.com]
1 Pen (£49.99 per pen)
49.99 GBP = 65.94 USD
Welcome again to why the American healthcare system sucks.
And, to be honest, I'm not even sure you aren't given EpiPens on prescription in the UK, in which case it would only cost £8.40.
(Score: 2, Insightful) by Anonymous Coward on Tuesday August 23 2016, @08:53AM
The U.S. health care system sucks because it is "for profit". That means it is in the Hospital's and Drug Company's interest to maximize profit. If they could kill you and still make a profit, you could damn sure bet that it would be done. People balk at government run health care, but there is no profit motive in it.
(Score: 2) by isostatic on Tuesday August 23 2016, @08:56AM
Americans balk at it. The rest of as simply relieved.
(Score: 2) by ledow on Tuesday August 23 2016, @09:51AM
And that's precisely why US healthcare sucks.
It has nothing to do with making people better. It has everything to do with extracting money from them.
Make people live longer, work longer, and be healthy for longer, and they much more tax than anything you could get from tax on what the healthcare industry can squeeze out of them while they're still able to pay.
But the US don't understand that. At all. I can't fathom it.
"Pay me for this pill." "Does it work?" "Maybe, but it makes me lots of money". Why the hell would you go to that doctor or listen to what he has to say?
In Britain, we spend our time at the doctors thus:
"Have this pill. And this one. And this one. They have to have met a certain standard of efficacy to be offered to you and cost nothing more than an administrative charge (or free if you can't afford that) even if it's a expensive and prolonged course of cancer drugs. And I get NOTHING back from saying you should have this one over any other." "Thanks." "Oh, and don't forget to come back next month for your free check-up".
(Score: 4, Insightful) by bzipitidoo on Tuesday August 23 2016, @01:19PM
It's a lot sicker than that. The poor get the thrilling choice of dying or being scorned for being ungrateful and cheating those poor, heroic doctors. They forgo health care and let health problems fester and get worse, until it is a medical emergency. Then they go to the emergency, which is legally required to treat them no matter how unable to pay they are. Sometimes they don't make it, dying before the hospital can save them.
Afterwards, if they're still alive and able, they soon get yuuuge bills they can't possibly pay. Some try to pay it off in installments over a very long time. But many have little choice but to stiff the doctors. So, next, the debt collectors come calling with threats to trash their credit rating even worse than it already is, and finally threats to sue them. And sometimes it does go that far, and the patient has to make a court appearance, or lose by default. Show up and lose, or don't show, either way the poor citizens may see their pathetic little bank account seized, 100% of the money taken, which upends their precarious lives because suddenly all their payments, for basic utilities and food and the like don't go through, and the bank gleefully piles on with big fees. The courts can also garnish pay, but that is limited to a mere 25% of each paycheck, can't take 100% like they can with a checking account.
One result of all this exertion to squeeze blood from stones is to make official that M. Citizen is very naughty, and deserves punishment. The system almost seems set up to put good citizens in that position. But I've concluded that refusing to pay outrageous prices is about the only viable thing a person can do. I've tried working within the system, using their internal appeals processes to contest amounts and choices. It was no good. Heard another story of a father whose son went to one of those urgent care facilities, complaining of abdominal pains. They ran up a huge bill of around $5000 running every test they could think of, and concluded that the young man was suffering from... constipation! Son couldn't afford that, so they went after dad. He angrily refused to pay.
Sadly, Obamacare hasn't improved matters much. We need more reform than that. Even with health insurance, a citizen can be hit with massive medical bills. Over half of all bankruptcies are thanks to medical bills.
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @04:11PM
It's completely retarded. Plenty of moderately wealthy and rich US people say they don't want to pay for some poor person's healthcare - they say the poor people should have taken better care of themselves or worked harder etc.
The real retarded thing is, in most cases they still end up paying anyway!
1) As you say via poor sitting in ER till they get sick enough to get treatment. Guess who pays?
2) They commit a crime to get $$$$$ for healthcare. Guess who pays?
3) They commit a crime, intentionally get caught to get healthcare. Seriously, there are a fair number of people robbing banks for a dollar to get healthcare:
http://abcnews.go.com/Health/Wellness/nc-man-allegedly-robs-bank-health-care-jail/story?id=13887040 [go.com]
https://www.rt.com/usa/oregon-man-bank-robbery-healthcare-126/ [rt.com]
http://www.news-leader.com/story/news/crime/2016/06/29/judge-gives-lenient-sentence-old-man-who-robbed-branson-bank-health-care/86512770/ [news-leader.com]
http://www.theatlantic.com/health/archive/2013/02/on-purposely-getting-arrested-to-get-life-saving-surgery/273282/ [theatlantic.com]
And that's an even more expensive way of providing healthcare. Imagine how expensive it is to pay for the courts, police, counselling for the bank teller, prison for the robber AND the actual healthcare.
4) Or as you also mentioned, they pay and end up crippled by bankruptcy and less productive to society.
Sure some of them die quietly and conveniently, but not all of them.
Thus even if you're selfish, if you can't get out of paying taxes you'd prefer single payer universal healthcare[1] (I'd want one that's limited to a max $$$,$$$ per person per X years, if I'm that sick to require millions of dollars worth of healthcare and I'm not a billionaire I'm going to go for euthanasia whether other people agree or not. and even if I'm a billionaire if there aren't actually good treatments for my condition I'd throw a a party/festival instead maybe one for myself and selected guests and one for others who are more energetic).
[1] Unless you're one of those profiting greatly from all of this (merely working in the insurance industry doesn't count - because in other countries and systems you can still make a decent living working in an insurance company ).
(Score: 2) by tangomargarine on Tuesday August 23 2016, @01:49PM
"Pay me for this pill." "Does it work?" "Maybe, but it makes me lots of money". Why the hell would you go to that doctor or listen to what he has to say?
Because what else are you supposed to do?
"Is that really true?" "I just spent the last hour telling you to think for yourself! Didn't you hear anything I said?"
(Score: 2) by termigator on Tuesday August 23 2016, @05:30PM
Die.
(Score: 2) by Magic Oddball on Tuesday August 23 2016, @08:59PM
"Pay me for this pill." "Does it work?" "Maybe, but it makes me lots of money". Why the hell would you go to that doctor or listen to what he has to say?
Except the patient wouldn't be paying the doctor, and doctors working directly (e.g. on salary) for a medical center or HMO like Kaiser [kp.org] don't get kickbacks.
Until recently, my Kaiser prescription receipts let me know the original price for each drug that they had argued the company down from, and the numbers were still astronomical — in the hundreds for generics, sometimes into the $1,500+ range for a non-generic.
(Score: 2) by CirclesInSand on Tuesday August 23 2016, @12:10PM
The US healthcare system isn't "for profit", it is "for votes". The only way the price can be $500 is if there is no one selling it for less, and if no one is selling it for less, it is because the government isn't letting them, and if the government isn't letting them, the motive isn't profit, it's vote buying.
Stop attributing government corruption to free markets when there isn't even a free market.
(Score: 2) by FatPhil on Tuesday August 23 2016, @02:56PM
You are still seeing the free market even if it's not doing what you want a free market to do. But you're right, blaming the free market is wrong, as the invisible hand is actually a back-hander (and yes, that is deliberately a 3-way play on words).
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 2) by dry on Wednesday August 24 2016, @03:11AM
It's a free market, everyone is free to buy laws and politicians. The health industry has been smart enough to invest in laws and politicians, so they get rewarded for being good at business, thinking ahead and making good investments.
Perhaps you're one of those socialists who think that government should work for the people?
(Score: 3, Informative) by WizardFusion on Tuesday August 23 2016, @09:04AM
I get free prescriptions, so for me it would cost nothing. Woohoo for the NHS.
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @09:15AM
America, Fuck Yea !!
(Score: 2) by Dunbal on Tuesday August 23 2016, @12:06PM
That way they can deliver even more adrenalin/epinephrine when the person gets the bill.
(Score: 3, Disagree) by Username on Tuesday August 23 2016, @01:17PM
It’s priced and regulated that way to deter recreational use, just like all other stimulants.
(Score: 1, Insightful) by Anonymous Coward on Tuesday August 23 2016, @03:58PM
So why is the exact same thing but for horses so cheap?
It's just simple price gouging. Free market, jack the price as high as is profitable.
(Score: 2) by Username on Wednesday August 24 2016, @07:12PM
I do not doubt some price gouging goes on, but only reason a prescription is required is because epipens are a schedule II controlled substance. Epinephrine in vials are schedule I, same as heroin.
Vets do not need a hospital, prescription, a pharmacy, insurance(well, maybe malpractice but I doubt it costs as much as people doctors), etc. They just need their certification and they can buy direct from China. They get to bypass a bunch of red tape since nobody really cares about animals, businesses regularly lobby against it, and no political will want to increase the price of food.
(Score: 2) by bucc5062 on Tuesday August 23 2016, @05:12PM
Were that that the case explain the massive price differential between the price gouging US and what seems to be other sane, non-addicted 1st world countries. This price has nothing to do with the "stimulant" angle and very much to do with the we don't give a shit about people angle. Now that's very American.
The more things change, the more they look the same
(Score: 1) by dr_barnowl on Wednesday August 24 2016, @07:55AM
Adrenaline isn't fun. It's the "Oh shit, panic" hormone, not something nice and buzzy like caffeine or cocaine.
(Score: 3, Interesting) by Snotnose on Tuesday August 23 2016, @01:47PM
It's all generics are skyrocketing. I take 4 drugs, all over 30 years old. I don't have insurance. 3 years ago I was getting a 3 month supply of all 4 drugs for a little under $30. Went to renew them this January, they wanted close to $300. Used an app called GoodRx, found out I could get them at Von's for $60. Talked to the pharmacist, seems only 1 company makes the drugs and they're raising prices by a goodly amount.
When the dust settled America realized it was saved by a porn star.
(Score: 2) by FatPhil on Tuesday August 23 2016, @03:09PM
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @03:04PM
You need one of them free trade thinggys, then just buy it from a non corrupt country.
(Score: 2) by goodie on Tuesday August 23 2016, @04:36PM
My daughter has one (well actually several, because the daycare needs one, we have one at home + one in the diaper bag, and my parents too). In Canada these are refunded I believe (I wouldn't know either way my insurance would cover it otherwise). Anyway, this is a life-saving product (although I hope I never have to use it on her especially since the children's dose is the same until you're 12 or something... she is 2.). Some have said that it should be available along defibrillators in public places which would not be a bad idea as far as I'm concerned.
I don't know if this is related, but until last year we used Allerject (smaller, gives you voice instructions). Unfortunately, there was a massive recall due to some issues with the product, and we had to wait 2 or 3 weeks for Epipen to move their ass and ramp up production. I'm guessing that now people have switched and consider it "better" so they can do whatever they want with the prices those assholes. The fact that there is no generic for this is ridiculous, it's not like it's (1) brand new, or (2) super complicated to manufacture AFAIK. And don't get me started on the size of the thing, it's like carrying a dildo in a box ;).
(Score: 1) by J_Darnley on Tuesday August 23 2016, @06:53PM
> it's like carrying a dildo in a box
Okay, now I must know. What kind of dildo? A discreet one, a BBC, a horse, or a dragon?
(Score: 2) by Spook brat on Tuesday August 23 2016, @07:15PM
And don't get me started on the size of the thing, it's like carrying a dildo in a box ;)
I really don't get why the medical devices for epinephrine are so big, considering that the Army has basically the same thing in a much smaller package: atropine autoinjectors. [duckduckgo.com] It's closer to the size of a fat crayon, much easier to keep around. I guess the civilian version feels the need to write the instructions on the injector in big block letters?
Travel the galaxy! Meet fascinating life forms... And kill them [schlockmercenary.com]
(Score: 0) by Anonymous Coward on Tuesday August 23 2016, @10:57PM
More like the need to put warnings all over the place to keep some idiot from suing them into oblivion.
One of the top pictures on that search is the scene from The Rock where Cage uses one. One of my buddies laughed out loud when he saw that and loudly remarked, "so the chemical weapons specialist with two PH.D.s doesn't know how to use that either."
(Score: 2) by goodie on Wednesday August 24 2016, @02:45AM
Indeed. For Epipen, the injector is actually encased in a transparent plastic tube. So to get to the actual needle you need to go through that first, then do the injection while counting and holding firmly to the person's thigh or wherever you are doing the injection ("did you do it? Are you sure you did it right? Did you count? Until how much?" are all questions I can see me and my wife freaking out about if we ever have to do it).
In comparison, Allerject is a much smaller device (more like a pack of cigarettes but smaller) that is easy to gain access to and actually speaks to you. That's why we liked it better and we took it so that my parents could more easily follow it if they ever needed to use it on our daughter.
The pharmacy originally gave us trainers for both so that we could try it, choose which one we liked better and make others practice too.